We’re well past the point where anyone could accuse Steven Soderbergh of resting on his laurels. Safe to say that his “I’m retiring” prattling during the Side Effects (2013) and Behind the Candelabra (2013) rollouts — whipped up into a state-of-the-cinematic-art lament by the Moloch that is the 24-hour news cycle — was more off-hours musing than prophetic threat. Now perhaps we can go back to judging his work as we should most art: project by project. As it comes, when (and if) it comes. Our clocks aren’t, and shouldn’t, be his.

Appropriate, then, that Soderbergh’s new undertaking — Cinemax’s period hospital drama, The Knick, of which he directed, edited, and photographed all ten first-season episodes — begins in the nebulous space of an opium den, where time evaporates in benumbed bliss. The high is short-lived: No sooner have we settled into the sensational first shot (POV over a propped-up pair of feet in unlaced white shoes, the red, womblike background soothingly blurred) than a clinical supertitle appears (“New York City 1900”) and a Chinese woman’s voice intrudes on the reverie. “Johnny … Johnny … it’s seven and a half. You said seven and a half?”

Think of the sublime final shot of Sergio Leone’s great gangster epic Once Upon a Time in America (1984), and imagine if Robert De Niro’s Noodles was suddenly dislodged from his doped-up euphoria by the horrible realization of Shit, I gotta get to the office! He might look something like the dapperly disheveled Dr. John Thackery (Clive Owen) as he stumbles, medical bag in hand, toward a carriage and instructs the driver to take the long way to work. (“I don’t want faster. I enjoy waiting.”)

The extended ride allows us to get acquainted with the vividly squalid Manhattan that Soderbergh and his collaborators have conjured: Dirt roads flecked with mud puddles (plus a dead horse in the gutter), fetid fog floating across the frame (thank heaven Smell-o-Vision never became a thing), and a charismatically damaged protagonist (every cable drama needs one) who injects himself, right between the toes, with liquid cocaine to get himself in working order. A flashback later in the episode reveals how Dr. Thackery first got hooked on “Uncle Parker”; he can thank his mentor Dr. J.M. Christiansen (Matt Frewer, Max Headroom himself), whom we meet after Thackery sidles into the beleaguered Knickerbocker Hospital (aka the Knick), which is the series’ primary setting.

Related Stories

The thick-bearded Christiansen — who, in a particularly humorous and humanizing moment, casually dips his bristles in a sterilizing bath — is about to preside over a “placenta praevia” procedure in the hospital’s “theater,” where students, fellow surgeons, and those all-important money men can observe what, at best, is medical history in the making and, at worst, sanctioned butchery. Along with assistant chief surgeon Thackery, also attending are Dr. Everett Gallinger (Eric Johnson), Dr. Bertram “Bertie” Chickering Jr. (Michael Angarano), and Nurse Lucy Elkins (Eve Hewson), the primary supporting players. There’ll be time to get to know everyone later. For now, we watch them in action as the operation — which Christiansen has performed many times before, with numerous variations, and always with no success — goes horribly awry.

You’ll probably know where you stand with The Knick after this early sequence. It typifies the antiseptic visual approach Soderbergh has honed since Traffic (2000), when he fully dispensed with outside DPs and became his own cinematographer. Many filmmakers would milk the moment when the pregnant patient begs, “Please save my baby,” before being put under (as it turns out, permanently). Soderbergh presents it as a mere statistic no more or less important than graphic incisions, claret-filled jars, or a dead infant. (“It seems we are still lacking,” sighs Christiansen in the bloody aftermath.) A wince-inducing moment quickly follows as Christiansen, distraught by his latest failure, puts a pistol to his head and blows his brains out. (That subsequent flashback, though, suggests we haven’t seen the last of him.)

One smash-cut to a coffin later and Owen gets his “big” scene, in which Thackery eulogizes his mentor before a church congregation that includes more supporting characters, among them hospital administrator Herman Barrow (Jeremy Bobb), board-of-trustees proxy Cornelia Robertson (Juliet Rylance), and Sister Harriet (Cara Seymour), an Irish Catholic nun who runs the Knick’s orphanage. Thackery’s monologue epitomizes something sour about the production, which frequently seems in a push-pull between the strength of Soderbergh’s filmmaking and the conventionality of the writing by series creators Jack Amiel and Michael Begler.

To a degree, this sequence is meant to be flowery. (“J.M. and I spent our lives tilting at the very same windmills,” and “I will not stop pushing forward into a hopeful future” are among Thackery’s many purple pronouncements.) And Soderbergh makes sure to quickly juxtapose the character’s paean with a moment in which Robertson and Sister Harriet remark on his speech’s “self-aggrandizing” nature. Yet the scene still feels like too much of a series mission statement — both a contrived means of exposition (as Thackery schools his audience, on- and offscreen, with the exciting advances in medicine that the year 1900 has and will continue to provide) and a cagey way to allow Owen’s natural charisma to sand down Thackery’s sharp edges. We like our cable heroes rough, but not that rough.

The thing of it is, Soderbergh isn’t having any of Amiel and Begler’s TV-shorthand shit. And you can sense this tension in a later scene in which the series’ co-lead Dr. Algernon Edwards (André Holland) makes his first appearance. Edwards is a distinguished Harvard graduate whom Robertson insists — at a hastily called board meeting — will be the now-promoted Thackery’s new assistant chief surgeon. (Thackery was angling for Dr. Gallinger.) Edwards also happens to be black, a fact that the progressive-to-a-fault Robertson conveniently hides from Thackery. My impression is that Amiel and Begler have written Thackery and Edwards’s first meeting — by the hospital’s basement furnace, where our soot-covered anithero is forging a new instrument that he’ll use in the episode’s climax — as a comic moment: Thackery can have his “Dagnabit, a Negro!” double-take, the well-spoken Edwards can seem unerringly noble, and the viewing audience can laugh, in that mock-enlightened way that is its own form of ignorance, about how racist we all used to be.

The way Soderbergh attacks the scene, however, pretty much neutralizes the problematic text. Thackery’s reaction to first seeing Edwards is kept at a distance since Soderbergh doesn’t cut in for a close-up. (He seems to be focusing more on the sudden chill in the air between the two men.) And this allows some of the easy ironies in the dialogue (e.g., “Is your race listed on [your credentials]?” asks Edwards. “There’s no need for it to be,” replies Thackery) to land with a force unburdened by retroactive broad-mindedness. In short, Soderbergh makes the past — that foreign country — feel present. (Pace L.P. Hartley, they don’t do things all that differently there.)

Edwards is understandably embarrassed at being made a mockery of, not only by Thackery, but also by Robertson and her too-eagerly liberal desire to integrate the Knick. She eventually forces Thackery to take on the man administrator Barrow nonchalantly calls “that dusky coon” by threatening to stop the gaslit hospital’s electrification. (If they won’t be enlightened, she’ll take away the light — clever.) Not that that prevents Thackery from treating Edwards like an inferior, and most everyone aside from Bertie (whose youth and protégé’s position affords him a less hardened perspective) follows suit.

The situation comes to a head when one of Dr. Gallinger’s recuperating patients requires a second bowel surgery (the first procedure failed, it’s strongly implied, owing to Gallinger’s overconfidence in his abilities). Thackery banishes Edwards, making him watch from the sidelines. Edwards, realizing he’s assistant chief surgeon in name only, tenders his resignation, to the visible relief of most in the room. But then he watches as Thackery uses that tool he was forging at their first meeting to correct Gallinger’s mistakes and, effectively, change the way this complication-ridden procedure is performed. “I’m not leaving this circus,” Edwards finally says, “until I learn everything you have to teach.”

Even the ignorant can impart wisdom, it would seem. But that’s for another day. For now, his work done, Thackery slinks back to his Chinatown opium den for another narcotized respite. And the Knick itself comes into the 20th century, as the technicians finish their wiring and electric lights illuminate the hospital’s hallways for the first time. Progress? That’s TBD.

Additional remedies

One of the characters I didn’t mention above is Tom Cleary (Chris Sullivan), the Knick’s prickly, foul-mouthed Irish ambulance driver, who’s more than willing to beat up rival hospital employees to procure a patient. His professional partner, Eldon Pouncey (Lucas Papaelias), is the Stan Laurel to his Oliver Hardy, but Cleary’s real barbs are saved for Cara Seymour’s chain-smoking Sister Harriet, whom he seems to get a special charge out of antagonizing. “You penguins just ever want to go for a good poke?” he charmingly asks. Though she gives as good as she gets: “Your ugly mug’s responsible for more girls staying virgins than a chastity belt.” Below-the-belt Tracy and Hepburn, that.

A B-plot that’s sure to take precedence in the coming weeks is the one involving Health Department inspector Jacob Speight (David Fierro), a portly prick, always willing to take a bribe, who brings an immigrant woman in the final stages of tuberculosis to the Knick. While Speight pushes administrator Barrow for a payoff, the woman’s plight catches the eye of Cornelia Robertson, who’s clearly raring to take on as many causes as possible. This situation seems like it has potential.

Eve Hewson’s West Virginia–bred Nurse Elkins is mostly a green figure of fun (Thackery scolds her for incorrectly changing a patient’s dressing), as well as a potential love interest (Bertie politely flirts with her). But she proves her mettle after she races to Thackery’s brownstone to get him for that climactic emergency surgery. She finds him in withdrawal (he was trying to go one night without a cocaine hit) and has to inject him in the only vein available — in his urethra. Reader, I cringed. She didn’t.

Ecstatic praise to The Knick’s droning electronic score by Cliff Martinez, which is like if John Carpenter decided to go all Banksy on Merchant/Ivory. Next to Soderbergh’s direction, the music is an element of this promising new series that is pretty much above reproach.